Maxillary Sinus Augmentation with Anorganic Bovine Bone Mineral of Different Particle Sizes: A Split-Mouth Study with Histomorphometric, Radiographic, and Clinical Analyses.

This article focuses on a randomized controlled split-mouth clinical trial comparing the effects of small (0.25–1.0 mm) versus large (1.0–2.0 mm) particles of deproteinized bovine bone mineral (DBBM; Bio-Oss, Geistlich) used for maxillary sinus augmentation. Histomorphometric analysis showed comparable new bone formation (NB) and residual graft percentages between the two particle sizes, but small particles demonstrated significantly higher bone-to-graft contact (BGC), indicating greater osteoconductivity. Radiographic measurements revealed similar graft stability over a four-year period for both particle sizes, with about 10% vertical graft height reduction predominantly occurring before implant placement. Clinically, all implants survived with healthy peri-implant conditions and minimal marginal bone loss at three years post-loading, regardless of particle size. The study concludes that both small and large DBBM particles are effective for sinus augmentation, with small particles offering higher osteoconductivity and large particles providing greater initial graft stability and volume efficiency, though these differences did not affect overall clinical outcomes.